Archived: The Bay

Updated 25 March 2016

We carried out this inspection under Section 60 of the Health and Social Care Act 2008 as part of our regulatory functions. This inspection checked whether the provider is meeting the legal requirements and regulations associated with the Health and Social Care Act 2008, to look at the overall quality of the service, and to provide a rating for the service under the Care Act 2014.

This inspection took place on the 14 January 2016; we called back on 15 January 2016 to meet with people who were out the previous day so that we could hear about their experiences. The inspection team consisted of one inspector.

Before the inspection, the provider completed a Provider Information Return (PIR). This is a form that asks the provider to give some key information about the service, what the service does well and improvements they plan to make. We also looked at all the other information we held about the service, including previous reports, complaints and notifications. A notification is information about important events which the provider is required to tell us about by law. We used all this information to decide which areas to focus on during our inspection.

We met all the people that lived in the service during the inspection except one who was unwell. Most were able to speak with us directly about their views of the service, for a few people who were unable to comment for themselves we used the Short Observational Framework for Inspection (SOFI). SOFI is a way of observing care to help us understand the experience of people who could not talk with us. We spoke with the registered manager and three care staff during the inspection. We contacted a range of health and social care professionals who knew the service and received feedback from three and they raised no issues of concern. We also spoke with one relative following inspection who spoke positively about the service.

We looked at three people’s support plans, activity planners, health records, and individual risk assessments. We also looked at medicine records, menus, and operational records for the service including: staff recruitment, training and supervision records, staff rotas, accident and incident reports, and servicing and maintenance checks.

Updated 25 March 2016

We carried out an unannounced inspection of this service 14 January 2016. The Bay is a service for eleven people with learning disabilities. There were no vacancies at the time of inspection. The Bay consists of two detached, adjacent houses with a communal garden at the rear. It is situated in a small close about a mile from the coastal town of New Romney. At a previous inspection on 13 January 2014 we found the provider was meeting all the requirements of the legislation.

There was a registered manager in post. A registered manager is a person who has registered with the Care Quality Commission to manage the service. Like registered providers, they are ‘registered persons’. Registered persons have legal responsibility for meeting the requirements in the Health and Social Care Act 2008 and associated regulations about how the service is run.

Recruitment processes did not have all required checks and information about staff was not in place. A range of individual and generic risk assessments were in place and these were kept updated; staff encouraged people to be independent but important risk information to support some of their independent activities was not in place and could place them at risk. There was not enough staff available to ensure everyone’s activity needs and preferences could be met throughout the week or that a good standard of cleaning was maintained in the service. Staff understood people’s individual care and health needs but required more information about how to support some specific health conditions in accordance with national guidance. Staff interactions with people were seen to be appropriate, kind, and caring. People were relaxed in the company of staff and said they were happy and felt safe.

Staff knew how to protect people in the event of a fire as they had undertaken fore training and took part in practice drills, but people’s individual evacuation plans to inform staff of their specific needs in evacuation were not in place.

A range of audits and quality checks were in place but these had not highlighted the issues found at inspection and were not used effectively to identify and act on shortfalls in the service. People wanted more information but were not always provided with information in formats they could easily understand. People and relatives were asked to give their views about service quality but their feedback was not always analysed sufficiently to inform service improvement.

The premises provided a comfortable home for people but wear and tear in some areas required redecoration; repairs were not always completed in a timely manner. Equipment checks and servicing were regularly carried out to ensure the premises and equipment used was safe. Fire detection and alarm systems were maintained Guidance was available to staff in the event of emergency events so they knew who to contact. is

Staff received induction to their role and training to give them the skills and knowledge needed. Staff were supported through supervisions and appraisal of their work performance and personal development. Staff had been trained in how to protect people; they knew the action to take if they suspected or witnessed abuse towards people. They were confident they could raise any concerns with the registered manager or outside agencies if this was needed.

People’s routines were flexible and staff supported them in accordance with their support plans. Staff respected people’s dignity and privacy. Staff were trained and understood the strategies they needed to use in supporting people whose behaviour could be highly anxious or challenging. Staff understood and worked to the principles of the Mental Capacity Act 2005.

People chose what they wanted to eat and said they enjoyed their food. People were supported to attend health appointments and staff ensured appropriate referrals were made to assure people’s health and wellbeing.

People were kept informed about the complaints procedure and relatives felt confident of raising concerns with staff if necessary. People were given opportunities to meet with staff to discuss their care and treatment. A relative confirmed that they were kept informed and had been consulted about the persons care and treatment plan.

People were supported by staff to maintain important relationships. Relatives were always made to feel welcome and they and other professionals said communication was good. Staff felt supported and able to express their views.

Accidents and incidents were monitored by the provider to see where improvements could be made to prevent future occurrence. Policies and procedures were updated centrally and sent around for staff to read to ensure staff worked to current guidance. The registered manager ensured agencies including the care Quality Commission were informed of significant events.

We have made four recommendations:

We recommend that the provider review guidance in relation to the development of personal evacuation plans in line with their responsibilities under current fire legislation Regulatory Reform (Fire Safety) Order 2005.

We recommend that the provider ensure that individualised condition specific support plans for Diabetes are developed in accordance with guidance from Diabetes UK.

We recommend that the provider reviews current best practice guidance around the availability of information in formats suitable for people to understand.

We recommend that the provider review concerns and complaints procedures to ensure that this is fully accessible and representative of the experiences of people in the service.

We recommend that support to develop people’s independence and life skills is shown clearly through the setting of achievable goals and the monitoring of progress towards these

We found breaches of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. You can see what action we asked the provider to take at the back of the full version of this report.